Do we really need to see the dietitian?

While we were waiting for confirmation, we had a call from the paediatric dietitian who was very keen to see Tamsin before the new term started. She emphasised what a critical age this was for Tamsin physically and how important it is to get her diet right now. I promised to call as soon as we knew, which I did, and today we had the visit.

I was a bit meh about having to drive to the city, pay a fortune for parking and lose two hours of my life when I’m a keen cook and understand about how to avoid gluten, but that was a serious misjudgment on my part. Providing gluten free foods is just the start.

Contamination

Logically it makes complete sense that safe GF foods can be contaminated by gluten-containing foods, but I simply hadn’t realised that coeliacs can be that sensitive to gluten. Tamsin and I both came out struck by contamination more than any other aspect the dietitian had discussed. At home it means Tamsin needs a separate toaster, separate butter (a knife used to spread butter on gluten-containing toast then put back in the butter effectively contaminates that butter for a coeliac), freshly cleaned utensils dried with a newly clean tea towel – no making a ‘normal’ sandwich on a board, brushing the crumbs off into the sink then putting the board back for the next person.

In the immediate aftermath of the appointment, I put a brand new block of butter in a clean butter dish for Tamsin and put a rubber band round it for easy identification. So far I’ve resisted the urge to designate separate utensils for her, but I’m washing anything I use to prepare food for her, such as the choppin board and knife used to make the sandwiches I sent with her to her sleepover. For main meals this won’t be such an issue as all our suppers will be gluten free/coeliac safe, but Tamsin will need breakfast and lunch or a packed lunch for school.

We were advised to make the GF packed lunch first and make sure any GF foods are cooked above non-GF in the oven. I’m already aware of that sort of thing from catering for vegetarians and non-vegetarians, though usually we all eat vegetarian main meals. It will be harder for Tamsin in her Food Tech lessons, so I need to have a meeting with the teacher and talk all this over with her.

Possibly more of an issue is a proposed school trip to three eastern European countries next year. As the dietitian talked about ensuring chefs were gluten free cooking trained I felt my optimism drain away. That sort of thing seems impossible to ensure with any certainty. It’s hard enough in the UK (I don’t fancy my chances of a straight conversation about gluten free cooking standards in my local Chinese takeaway, and we don’t live somewhere with much choice), but factor in a hefty language barrier and completely different culinary cultural norms and it feels completely unfeasible.

Diet

Tamsin is 14 and growing fast, and as her system starts to heal (which I’m told can take a year) and she benefits from more and more of the nutrition in her food she’ll make up for lost time. It’s important for any teenager to eat well and be well-nourished, but a coeliac has ground to make up.

We were advised that Tamsin needs to have the equivalent of a pint of milk a day. Her usual breakfast is chopped fruit, natural yoghurt and oats, which makes a contribution to that, cheese features a lot in my cooking and she can have a hot chocolate every day, so I think we can get to a pint without much trouble. I meant to ask about food supplements but forgot, but the woman was so thorough I think she would have mentioned it if it was necessary.

Prescription foods

Tamsin is entitled to GF foods on prescription until she’s 18, though we were told that some areas are phasing it out now that so many GF foods are available in the shops. The foods are all breads, pasta and pizza bases, but there’s lots of choice within that, including bread mixes and ordinary cooking flours.

Tamsin is allowed 15 units a month and unless I make a change with the dispensary she’ll get the same foods each month. We’ve started with various choices, taking into account school lunches, but we’ll see how it goes and make changes if we find we’re drowing in pasta or running out of bread.

Coeliac UK app

The dietitian took us through everything we need to look for when we’re shopping. It became clear that the Coeliac UK app is going be indispensible as it tells you exactly which version of which products in which shops are coeliac safe. A handbook is produced once a year, but clearly that can’t stay up to date in the same way as the app. As Tamsin is under 16 I’ve joined on her behalf and I’ll be the one doing the food shopping, so the app is more use to her than to me for now. Having said all that, I can’t get any signal in Morrisons, unlike in Aldi, so the handbook will have its uses there.

There’s a free version of the app and the full version that you access once you’re a paid up member of the society. Needless to say, you have to be a member to access the food directory.